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MRS. KELLY ANNE BRAINARD LMFT

>> Rehabilitation Practitioner >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1699891366

Individual Registrant:
MRS. KELLY ANNE BRAINARD LMFT
Gender: F
Sole Proprietor

Location and contact information for practice:
25129 THE OLD ROAD SUITE 201 STEVENSON RANCH, CA 91381-2276 US
Tel: 661-294-3898  Fax: 661-294-3898

Contact information for business:
25129 THE OLD ROAD SUITE 201 STEVENSON RANCH, CA 91381-2276 US
Tel: 661-294-3898  Fax: 661-294-3898

Registration Information:
NPI: 1699891366
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225400000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Rehabilitation Practitioner
CAIMF 45082
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFC 44454

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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